An OB-GYN, a leading anti-abortion activist and a few Republican lawmakers worked together on a proposal, introduced Wednesday, that they say will give doctors some explicit clarity on when they can legally provide abortions to protect their pregnant patient’s life.
Dr. Jeff Goldberg told a legislative committee Wednesday there’s “a tremendous amount of ambiguity” in state law right now, making it hard for some patients to quickly get life-saving care. He sees the new House Bill 414 as an opportunity to make initial improvements that can pass Kentucky’s Republican-run legislature.
“We have come together to work on parts that we think, from a political standpoint, can be managed in the short term,” he said. “We're simply trying to ensure that, on a day-to-day basis, doctors feel comfortable providing evidence-based care for women with complications of pregnancy that, again, have nothing to do with elective abortion.”
Kentucky’s current ban makes abortion illegal unless there’s a life-threatening health risk. That would remain the case if the legislature approves HB 414.
The updated bill essentially adds explicit allowances for doctors to provide an abortion under certain circumstances. The permissible conditions include ectopic or molar pregnancies and cases of sepsis or hemorrhage when an impending or completed miscarriage causes a “life-threatening infection or excessive bleeding.”
The bill also says “lifesaving miscarriage management” is allowed during completed or “unavoidable” incomplete miscarriages, and it says doctors can remove an embryo or fetus after a miscarriage as long as fetal cardiac activity isn’t detected.
Democratic Rep. Lisa Willner of Louisville said the bill appears written in a way that can be read as requiring doctors to wait, in certain circumstances, until women are more endangered, not less, before they can act.
“I think the effort was to add clarity, but I think what it does is to codify that a woman has to suffer a lot … before the doctor is free and clear to treat that,” she said.
Goldberg indicated the goal of the bill is to prevent women from having their care delayed while they bleed out. He and the bill’s other architects also noted they see it as the start, not the end, of tackling this issue.
With limited time left in Kentucky’s annual lawmaking session, Goldberg said, “We have a few days to get some good done, as opposed to getting everything perfect.”
The proposal was introduced in and advanced by a House committee Wednesday afternoon.
Goldberg is the legislative advocacy chair for Kentucky’s chapter of the American College of Obstetricians and Gynecologists, a leading professional association that opposes bans on abortion. It was unclear, during Wednesday’s meeting, if the bill has the support of the local chapter as a whole.
Republican reps. Kimberly Moser, Jason Nemes and Nancy Tate worked with Goldberg and Addia Wuchner, executive director of the anti-abortion group Kentucky Right to Life, on the updated version of HB 414.
“There's been a lot of misinformation, a lot of concerns and fear, out there about what can be done in the medical practice. So jointly we worked together to put those fears at rest and make it clear,” Wuchner said.
Nemes said Goldberg called him months ago about pursuing legislation like this, but he didn’t think getting to this point would be possible. “But we have people who don't always trust one another, who've looked each other in the eyes, who’ve come up with this really good bill, I think…”
“A lot of people from all sides of this debate probably want to go further. I respect all those positions,” he said. “This is solving a discrete problem, and it will save the lives of mothers.”
Another key aspect of HB 414 is the bill basically wouldn’t count it as an abortion if a doctor ends a patient’s pregnancy under conditions deemed permissible by the state.
The bill’s architects indicated the goal there is to allay doctors’ fears that treating a life-threatening problem could be considered an illegal abortion.
In broadly accepted medical terminology, though, abortion refers to ending a pregnancy, regardless of the reason why.
Tamarra Wieder of Planned Parenthood Alliance Advocates said the bill’s redefinition of abortion mirrors language used by “anti-abortion extremist groups.”
She also said the way the bill adds the terms “lifesaving” and “life-threatening” to its provisions regarding miscarriage management, sepsis and hemorrhages actually could make doctors wait longer to provide an abortion in those circumstances. “This enshrines the delay,” she said.
“It is a very technical bill. And these technicalities and word choices matter, especially in care that is highly scrutinized and highly politicized,” she told the Kentucky Center for Investigative Reporting.
The House Health Services Committee, led by Moser, advanced the new HB 414 Wednesday, with Republican members voting in favor and Democrats against.
The updated version of HB 414 still does what the bill originally set out to do: Require health care providers to make perinatal palliative care services, like spiritual support and making keepsakes, available to pregnant patients if their embryo or fetus is diagnosed with a fatal condition.
The perinatal palliative care proposal failed to pass the legislature last year. Democratic lawmakers and reproductive rights advocates said the bill could make doctors even more wary of discussing other options, like going out of state for an abortion, with patients whose pregnancies are nonviable.
